Almost everyone can be affected by acne — yet no community pharmacies offer a service to help treat it. Are contractors missing a trick? Vincent Forrester investigates
Key learning points
- Pharmacies are well-placed to offer advice on acne
- Acne is less prevalent in adults, but a growing number are developing it in later life
- Skincare is a growing market that pharmacies can capitalise on
Acne is one of the most common skin conditions, affecting almost everyone at some point, usually during puberty or adolescence. According to the British Skin Foundation (BSF), this condition affects as many as eight in 10 people between the ages of 11 and 30.
The condition is less prevalent in adults – it affects about 5% of women and 1% of men – but anecdotal evidence suggests more people are getting acne later in life. A report in the Daily Telegraph in 2016 said that cases of adult acne had increased by 200%, and quoted a doctor, from a private skin clinic in London, who said the spike was ‘like an epidemic’.
According to a 2017 study by market researchers ReportLinker, more than 680 million people had acne is 2016, up almost 10% from the 2006 figure of 612 million.
The same study put the cost of acne – in terms of treatment and loss of productivity – at more than £2.2bn a year. Another report valued the market for acne treatment in 2016 at £3.6bn.
Since the symptoms of the condition are visible, it can be a major source of embarrassment and stress for those affected.
How can pharmacy help?
On the NHS’s website, its advice on the condition says: ‘Several creams, lotions and gels for treating spots are available at pharmacies. If you develop acne, it’s a good idea to speak to your pharmacist for advice.’
Of course, pharmacies regularly provide advice and treatment for acne. However, few – if any – provide a specific service, as they might for, say, weight management, flu vaccination or smoking cessation.
The closest offering to an acne service appears to be LloydsPharmacy’s skin analysis service. Anshu Bhimbat, a pharmacist at a Buckinghamshire LloydsPharmacy, describes it as ‘a test that looks at your skin as a whole’.
It’s a free service conducted by a pharmacist or a healthcare assistant, who will place a probe on the patient’s face at four points to check their skin for hydration, pH, elasticity, sebum, temperature and melanin levels.
‘According to the results, skincare advice can be given,’says Ms Bhimbat.
‘If hydration is low, we will recommend hydrating emollient creams or generally increasing water intake. If the pH level is low or high, a similar thing could be suggested.’
She says acne is ‘something that can be dealt with in pharmacy initially… it’s one of the self-treatable conditions that don’t necessarily need referral to a GP’.
While Ms Bhimbat stresses that LloydsPharmacy’s main concern is ‘to make sure we’re giving the correct healthcare advice’, she says the skin analysis service may end with a sale.
So, should independent community pharmacies take a leaf out of the multiple’s book and do more to serve those with acne — and find an extra revenue stream?
An emerging market
Gavin Birchall, a pharmacist and marketing expert who was formerly operations director of the MedicX pharmacy chain, makes the point that ‘pharmacists provide advice for skin-related conditions over the counter already, but maybe they haven’t thought of turning it into a service or product that they would market directly to customers’.
He agrees with Ms Bhimbat that there is a sales opportunity attached to acne. ‘The skincare market is massive,’ he says. ‘You only have to look to other countries where many pharmacies have an extensive section of premium skincare. Whereas in our country we tend to offer quite a range of skincare, but not at that premium end.’
Al Patel, a contractor at Lee Pharmacy in Lewisham, south London, who specialises in dermatology and asthma, says aftersales are ‘ideal’ for acne. ‘Sometimes the gels [used to treat acne] tend to peel the skin and the patient stops using it, because they feel as if it’s a side effect, when it’s actually the way the gel works. Follow-up is always very good for this — I think patients feel reassured.’
A pharmacy acne service is ‘a great idea’, according to Anton Alexandroff, because most cases are mild to moderate and can be treated over the counter.
Mr Alexandroff, a consultant dermatologist and a spokesperson for the BSF, says providing such care in the pharmacy ‘would be a great help for GPs, because it would offload a lot of patients and relieve pressure on doctors’.
Think about local population
While acne is very common, a service may be better suited to some pharmacies than others. Given that acne tends to affect young people, pharmacies close to universities and colleges may find that the demand is greater than at pharmacies in rural areas, where residents tend to be older.
However, Ms Bhimbat says this is not always the case, since parents often take charge of their children’s healthcare. ‘You’ll often have mum coming in, without the child, saying: “My child is starting to have acne, what can I do?”’ she says.
As when considering any service, it is essential to conduct market research, says Mr Birchall. ‘Make sure you understand what the customer wants and needs and if there is, in fact, a market for that type of service in your location,’ he says. ‘Identify who the target market is, which type of customers might be interested in the products you’re considering supplying and the type of service you’re considering delivering.’
If you decide that there is, indeed, demand for an acne service, the next
step is deciding what it should look like, where the consultation will take place, who will conduct the service and how it will be advertised.
Mr Alexandroff says the sensitive nature of the condition means ensuring privacy during the consultation is paramount. ‘Lots of patients find it embarrassing, so it’s better to have it in private,’ he says, adding that depression is ‘a really, really serious problem’ associated with acne. ‘It can affect relationships and even job prospects,[so] it would be useful to ask about low mood and depression, because it would be good to advise them to see a GP about this.’
Mr Patel says counter staff could help in an acne service, since most of the treatments do not require a prescription. However, he feels training in the specific medicines being offered is vital. ‘Pharmacies tend to get training before they start selling the medication,’ he says. ‘Mainly the manufacturer of the product would offer
a training package. Alternatively you’ve got online and e-learning courses.’
Perhaps the most crucial difference between the LloydsPharmacy skin service and anywhere else concerns pricing. Mr Birchall says that the business model of multiples do not apply to community pharmacies.
‘A pharmacist should always charge for their professional services, they should not rely on remuneration through products sale or supply. Full stop,’ he says. ‘We’ve too long relied on that as the funding mechanism and we’ve suffered as a profession as a result of it.’
Mr Patel says costing an acne service depends on the pharmacy offering it. ‘It would include the cost of the product and the consultation time — it would be a good 10- to 15-minute consultation including not only how to use the product, but also the skin regime, the condition itself, a little bit about diet, washing. So maybe the price of the product plus 10% to 15% extra.’
Ultimately, any opportunity for new services should be considered, he says. ‘I think it’s something pharmacies would be interested in, bearing in mind that there won’t be any new services given out in the next few years.
‘I think anything that can come through pharmacy would be absolutely fantastic.’